YOĞUN BAKIM ÜNİTESİNDE BEYİN HASARI OLAN HASTALAR ARASINDA BEYİN ÖLÜMÜ İNSİDANSI: RETROSPEKTİF ÇALIŞMA

Amaç: Beyin ölümü kavramı klinik olarak uyarılara tam cevapsızlık hali, solunum ve motor cevabın olmaması,beyin sapı reflekslerinin yokluğu ve koma tablosunun mevcudiyeti ile tüm beyin fonksiyonlarının tam ve geridönüşümsüz olarak kaybı ile karakterize bir klinik tablo olarak tanımlanmaktadır. Türkiye'de sınırlı donörkaynakları ve yüksek aile reddi nedeniyle beyin ölümü ve potansiyel bağışçıların belirlenmesi büyük önem arzetmektedir. Burada üçüncü basamak erişkin yoğun bakım ünitesinde beyin ölümü gelişen hastaları ve kadavradonörlerini geriye dönük olarak değerlendirmeyi hedefliyoruz. Materyal ve Metot: 2008-2019 yılları arasında beyin ölümü tanısı alan hastaların tıbbi kayıtları geriye dönükolarak değerlendirildi. Hastaların demografik özelliklerini, klinik tanılarını ve bağış oranlarını kaydedildi. Bulgular: 2008-2019 yılları arasında yoğun bakım ünitesinde toplam 102 beyin ölümü hastası teşhis edildi.Hastaların ortalama yaşı 49 (16-84, min-maks), %55,88'i erkek ve %44,11'i kadındı. Klinik tanılar spontanintrakraniyal kanama (%50), travmatik intrakraniyal kanama (%28,43), kardiyak arrest (%12,74) ve serebralinfarkt (%7,84) idi.19 (%18,62) hastada organ bağışı onaylanırken 83 hastada reddedildi. Yoğun bakımabaşvuru ile apne testi arasında geçen süre ortalama 3,56 gün olarak belirlendi. Sonuç: Bu çalışmada, beyin ölümü tanı oranlarının arttığını, ancak kadavra donörden organ bağışı oranlarındadeğişiklik olmadığını tespit ettik. Sağlık çalışanları, organ bağışı oranlarını artırmak için organ bağışı ve organbağışı gönüllülüğü konusundaki farkındalığı arttırmaya odaklanmalıdır.

INCIDENCE OF BRAIN DEATH AMONG PATIENTS WITHBRAIN INJURY IN INTENSIVE CARE UNIT: ARETROSPECTIVE STUDY

Objectives: The concept of brain death is clinically defined as the absence of spontaneous respiration, brain stem reflexes, and motor responses, presence of coma, and irreversible cessation of brain function, including the cerebral and brain stem functions completely. Because of limited donor sources and high family refusal in Turkey, to determine brain death and potential donors is very important. Here we aim to evaluate the braindead patients and cadaver donors in a tertiary level adult intensive care unit, retrospectively.Materials and Methods: We evaluated the medical records of brain-dead patients diagnosed between the years 2008-2019, retrospectively. We recorded the demographics of the patients, clinical diagnosis, and donation rates.Results: A total of 102 brain dead patients were diagnosed in the intensive care unit between the years 2008-2019. The median age of the patients was 49.16 (16-84, min-max), 55.88% was male and 44.11% was female. The clinical diagnoses were spontaneous intracranial hemorrhage (50%), traumatic intracranial hemorrhage (28.43%), cardiac arrest (12.74%), and cerebral infarct (7.84%). Organ donation was approved in 19 (18.62%) patients and refused in 83 patients. The time between admission to the intensive care unit and apnea test was determined as a mean of 3.56 days.Conclusion: In the present study, we recognized the increased rates of brain death diagnosis, but there was no change in donation rates of cadaver donors. Health professionals should focus on promoting awareness of organ donation and volunteering to donate in order to increase donation rates.

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